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Schüre JR, Casagranda S, Sedykh M, Liebig P, Papageorgakis C, Mancini L, Bisdas S, Nichelli L, Pinter N, Mechtler L, Jafari R, Boddaert N, Dangouloff-Ros V, Poujol J, Schmidt M, Doerfler A, Zaiss M. Fluid suppression in amide proton transfer-weighted (APTw) CEST imaging: New theoretical insights and clinical benefits. Magn Reson Med 2024; 91:1354-1367. [PMID: 38073061 DOI: 10.1002/mrm.29915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 02/03/2024]
Abstract
PURPOSE Amide proton transfer-weighted (APTw) MRI at 3T provides a unique contrast for brain tumor imaging. However, APTw imaging suffers from hyperintensities in liquid compartments such as cystic or necrotic structures and provides a distorted APTw signal intensity. Recently, it has been shown that heuristically motivated fluid suppression can remove such artifacts and significantly improve the readability of APTw imaging. THEORY AND METHODS In this work, we show that the fluid suppression can actually be understood by the known concept of spillover dilution, which itself can be derived from the Bloch-McConnell equations in comparison to the heuristic approach. Therefore, we derive a novel post-processing formula that efficiently removes fluid artifact, and explains previous approaches. We demonstrate the utility of this APTw assessment in silico, in vitro, and in vivo in brain tumor patients acquired at MR scanners from different vendors. RESULTS Our results show a reduction of the CEST signals from fluid environments while keeping the APTw-CEST signal intensity almost unchanged for semi-solid tissue structures such as the contralateral normal appearing white matter. This further allows us to use the same color bar settings as for conventional APTw imaging. CONCLUSION Fluid suppression has considerable value in improving the readability of APTw maps in the neuro-oncological field. In this work, we derive a novel post-processing formula from the underlying Bloch-McConnell equations that efficiently removes fluid artifact, and explains previous approaches which justify the derivation of this metric from a theoretical point of view, to reassure the scientific and medical field about its use.
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Affiliation(s)
- Jan-Rüdiger Schüre
- Institute of Neuroradiology, University Clinic Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Stefano Casagranda
- Department of R&D Advanced Applications, Olea Medical, La Ciotat, France
| | - Maria Sedykh
- Institute of Neuroradiology, University Clinic Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | | | | | - Laura Mancini
- Lysholm Department of Neuroradiology, University College of London Hospitals NHS Foundation Trus, London, UK
- Institute of Neurology UCL, London, UK
| | - Sotirios Bisdas
- Lysholm Department of Neuroradiology, University College of London Hospitals NHS Foundation Trus, London, UK
- Institute of Neurology UCL, London, UK
| | - Lucia Nichelli
- Department of Neuroradiology, Sorbonne Université, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Paris, France
| | - Nandor Pinter
- DENT Neurologic Institute, Buffalo, New York, USA
- Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York, USA
| | | | - Ramin Jafari
- Philips Healthcare, Cambridge, Massachusetts, USA
| | - Nathalie Boddaert
- Necker-Enfants Malades Hospital, AP-HP, Pediatric Radiology Department, Université Paris, Paris, France
- Imagine Institute, INSERM U1163, Université Paris cité, Paris, France
| | - Volodia Dangouloff-Ros
- Necker-Enfants Malades Hospital, AP-HP, Pediatric Radiology Department, Université Paris, Paris, France
- Imagine Institute, INSERM U1163, Université Paris cité, Paris, France
| | | | - Manuel Schmidt
- Institute of Neuroradiology, University Clinic Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Arnd Doerfler
- Institute of Neuroradiology, University Clinic Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Moritz Zaiss
- Institute of Neuroradiology, University Clinic Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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